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Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience:  Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
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Dr. Wilfong, do you have any advice about taking Lomotil (for

Resolved Question:

Dr. Wilfong, do you have any advice about taking Lomotil (for IBS/colagenous colitis? My gastro. prescribed it about 8 weeks ago, and it's an "opiate." Would it affect the celexa (20 mg) I take in the a.m. or the Lorezapam (1 mg) I take at night?
Also, do you have any acquaintance with patients taking Cymbalta? It is supposed to cause constipation (a side effect) so I'm wondering if I could take it and reduce or eliminate the imodium/lomotil /celexa. That would simplify my life and hopefully reduce the number of meds I take (they're getting expensive.).

My final question: I saw my neurologist last week, who had prescribed Atenolol to prevent migraines over a year ago, and I told her it was working very well for that purpose, but that I has done some online research (with you) and foumd that it could contribute to depression. She agreed that it could, but wasn't agreeable to my switching to a calcium channel blockers as a substitution She wrote me a prescription for Topomax, which I haven't started yet. Do you have any feedback on that medication?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Ed Wilfong replied 3 years ago.

Dr. Ed Wilfong :

Sorry this took so long. My computer went down and to ok a few days to fix. Lomotil is an opiate but a very minimal dose. It is so low you would have to take a pretty large overdose to feel any of usual opiate effects. It is safe with other medications. It should not interfere with any of your medications and work much better than immodium.

Dr. Ed Wilfong :

I have a lot of experience with cymbalta and actually like it. As for constipation, all these medications have a small incidence of constipation or diarrhea and it varies unpredictably from patient to patient. It usually has no effect, it just does in some people.

Dr. Ed Wilfong :

I am not certain if calcium channel blockers would help with migraines - just a little outside of my expertise. And atenolol when it causes depression usually does so quite severely and quickly and only does so about 10% of time. I am not sure, but I though you were take for blood pressure. Maxalt can be taken when you feel migraine coming on if they are infrequent. There is a concern about it causing serotonin syndrome, because it acts on serotonin. The neurologists I have talked to say the risk is much less than they originally thought as it works on different subset of serotonin (there are bunch of types of serotonin receptors).

Dr. Ed Wilfong :

Topomax is used for seizures and migraine prevention. It is likely to have more side effects than other meds you are taking, so I would give it a try and see how you react. You may want to go back to atenolol if it doesn't agree with you.

Dr. Ed Wilfong :

I am not familiar with Relpax, but doing a little research, it looks like same type of drug as Maxalt, so forget about the maxalt.

Dr. Ed Wilfong :

The FDA recently issued a warning about celexa - it can cause some cardiac aryhmia's and q-wave changes. They say it occurs only at 40 mg and above and they only have about 100 reported cases, so I am not sure how serious to take the warning. In any event, I do like cymbalta better, but again it varies from person to person which works best. If you have a fixed copay it might be worth changing, otherwise

Expert:  Dr. Ed Wilfong replied 3 years ago.
... otherwise celexa may be less expensive.
Walmart often has good prices on meds.

In short, lomotil good idea.
Atenolol may be preferred to topomax - you can decide.
Cymbalta may work better for depression, but would likely be neutral toward colitis.

I had to switch to Q/A format as chat Locked up on me (happens a lot). You can still ask follow-up if needed.
Customer: replied 3 years ago.

What are q-wave changes? (associated with some celexa takers)

 

I think you've helped me decide to go to cymbalta, continue lomotil, and stick with atenolol. I've been anxious to refine my meds for maximum benefit and minimum side effects. I appreciate your insight.

 

Customer: replied 3 years ago.

What are q-wave changes? (associated with some celexa takers)

 

I think you've helped me decide to go to cymbalta, continue lomotil, and stick with atenolol. I've been anxious to refine my meds for maximum benefit and minimum side effects. I appreciate your insight.

 

*****************************************************************************************

I forgot to ask---what's the safest way to got from celexa 30 mg (I've been taking one and a half) to cymbalta? What's a good level of cymbalta to start? 20? 30? I have a friend who is finally up to 60 and says it's like the sun came out on a dark day.

 

PS--I read that 80% of our serotonin is produced in the "gut." Since I've always had busy bowels--frequent movements, IBS, etc. --and my gastro says I don't absorb food/liquids very well, could lack of intestinal absorption cause depression in patients? It seems like a logical conclusion.

Expert:  Dr. Ed Wilfong replied 3 years ago.
Q-wave changes (I am not cardiologist) I believe is a cardiac arythmia. Actually, I think atenolol may be a treatemnt for it, but I am only making educated guess. Q-waves are how it shows up on EEG.
I would just make switch directly to Cymbalta after skipping Celexa for a day. Start at 30 and go to 60 in 7-10 days.
Haven't heard about serotonin produced in gut. I do know a lot of people get blood level checked, which is meaningless. The reason is the serotonin used in brain is produced in brain. (It is also used in other parts of body - I am only good for stuff above the neck...). For chemicals to be used in brain, it has to cross blood/brain barrier
It is interesting theory....if you have a link to a reference, I would like to check it out.
Good luck on cymbalta and with IBS.
Ed
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience: Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
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Dr. Ed Wilfong
Dr. Ed Wilfong
Licensed Psychologist
1524 Satisfied Customers
Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.